Provider Demographics
NPI:1598908634
Name:SMITH, LOLITA MARIA (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MISS
First Name:LOLITA
Middle Name:MARIA
Last Name:SMITH
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N CHARLES ST
Mailing Address - Street 2:301
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-4360
Mailing Address - Country:US
Mailing Address - Phone:443-872-5847
Mailing Address - Fax:
Practice Address - Street 1:312 N CHARLES ST
Practice Address - Street 2:301
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4360
Practice Address - Country:US
Practice Address - Phone:443-872-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-18
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist